Monday, June 1, 2015

Health: The Effects of Dumsor on health-cold chain medicines

Cold chain medicines are drugs that need to be in a specific temperature for them to work. In this case, they have to remain cool, cold or frozen depending on the medicine for its efficacy to be maintained. However, recent power outages are causing much harm-to patients and to pharmacy owners as well. The details of this issue will amaze you.

The load shedding exercise is affecting almost all sectors of the economy and the pharmaceutical sector is not exempted. Some medicines used by some patients are not working as it should be because their efficacy has been compromised due to unstable power supply.

Here is a story of how an encounter with a patient gingered me to write this article into the public domain.

Gloves on, disinfectant application-checked! Glucometer is ready…ready? And pinch! Blood oozed from her shaky tiny fingers and sample for her blood sugar testing was carried out. It turned out to be high…too high.

My patient looked worried and she blamed her insulin citing that they were ineffective of late as it was at first.

“Tell me about it-how do you store them?” I enquired.

After a long investigative chat, only one conclusion was indispensable-Dumsor was the culprit.

Insulins must be kept refrigerated. As a pharmacist, it is my job to ensure that but when the medicine leaves the auspices of the pharmacy, the patient is entrusted with this role.

Sure, there are other medicines that require refrigeration in order to work – anti Rabies (for dog bites treatment), anti-Snake (for treatment of snake bites) anti-D (to avoid disease of the newborn in some pregnancies) and several other important drugs that cannot be effective when stored under ‘anti-Light’ (Dumsor) conditions.

The effect of Dumsor on community pharmacies is very huge and serious matter that needs immediate attention if more lives can be saved. Every good pharmacist, who I believe many colleagues are, does not seek to make more sales as he seeks the best interest of his patients or clients.

Yes, pharmacists have the right to pressure authorities to find a lasting solution to the Dumsor that is destroying businesses.

The insulin for diabetics like the worried patient I talked about early on is very expensive with the average price of GhC 60 per vial as at May 2015 which can at most last for a month depending on the dosage regimen. This is usually not the only medicine that a diabetic will be put on but others that go a long way to improve the quality of life for these usually poor patients. For Dumsor to add to their worries by rendering their stored medicines ineffective is uncalled for.

It is in rare cases that you come across insulin that are cloudy from disintegration. It is usually clear and these unsuspected patients may inject “placebos’ into their thighs and other places hoping for their sugar levels to come down to normal only to see it skyrocket.

This is not a platform to educate you on the effect of uncontrolled blood sugar but just to make a point let me touch on a few: blindness, amputation of limbs and for men, Jack may forever sleep.

Enough of the patient let us look at the scenario where insulin is ineffective even before they leave the pharmacy. I will not lie to protect my own. A bitter truth is better than a sweet lie. Some pharmacy owners without enough funds or resources to purchase a generator or enough knowledge to know how essential the temperature of drugs are not willing to buy a standby generator that powers up automatically when unannounced power outages are carried out. This can make cold chain medicines such as insulin go bad and refusal to bear the cost can motivate these shop owners to sell the ‘spoilt’ medicines to unsuspecting customers This is sad indeed.

Before you judge for yourself how bad Dumsor must stop, consider a pharmacist who closes his shop late at night, leaving the refrigerator on, hoping that the power will be on till another twelve hours but deep in the night while he sleeps, the power is cut with no regard to the load shedding timetable. Worse, the power comes on an hour or so before the pharmacy opens. The cold chain medicines may look good and the thermometer may read fine but only God knows if they will work in a patient or not.

You may be wondering if the medicine in this scenario might work again when the power is restored. Let me leave the answer to your imagination: If a ball of kenkey was washed clean despite been taken out of a garbage can, will you still eat it?